Pubdate: Thu, 11 Sep 2014
Source: Georgia Straight, The (CN BC)
Copyright: 2014 The Georgia Straight
Author: Travis Lupick


DOWN THE HALL from the supervised injection room at Insite, there's a
mostly unused space that years ago was haphazardly filled with boxes.

Unique for a storage space, it's outfitted to accommodate heavy
air-handling units powerful enough to create negative room pressure.

Over coffee earlier this summer, Portland Hotel Society (PHS)
cofounder and former executive director Mark Townsend explained that
Insite was originally planned to provide services to a variety of drug
users. The room stuffed with boxes was designed as a place where
people addicted to crack cocaine could smoke the drug in conditions
that minimize risks of fatal overdose and infection, he said.

"We were working on it," Townsend added. "We got a quote to set the
room up, we got an architecture drawing ready for the tenant
improvement for the space, we even had meetings about whether it would
be captured in the nicotine smoking rules or not. But really getting
it done, the big impediment was obviously the federal

An inhalation room for crack users is the kind of idea for which PHS
is best known. Crack pipe vending machines, a "Drinkers Lounge" that
helps alcoholics brew their own beer, and Insite itself are
once-experimental harm reduction programs that proved themselves successf

Combined with former mayor Philip Owen's "Four Pillars" shift on
policing and health care, those sorts of harm reduction programs are
largely credited with significantly reducing overdose deaths and the
spread of HIV/AIDS. But statistics show there's still work to be done.

According to a June 2014 report by the B.C. Coroners Service, in 2013
there were 103 fatal overdoses attributed to illicit drugs in Metro
Vancouver. That marked a five-year high, up from 78 deaths in 2009.

With PHS's old management team disbanded last March following a
controversial financial audit, some advocates question if Vancouver's
push on harm reduction has run out of steam.

In a telephone interview, Adrienne Smith, a health and drug policy
advocate with Pivot Legal Society, said that there's probably less of
an appetite for potentially controversial programs since the PHS audit
was made public.

"The Portland Hotel Society would have been the obvious driver for
something like that [an inhalation room]," she said. "I think Portland
is not in a great place to advocate for projects like that right now."

Smith argued there's still a need in Vancouver for innovative harm
reduction strategies.

"What we learned from Insite=C2=85is that any exposure to regular and
normalized health-care services for drug users is beneficial to them
and beneficial to the community," she said.

Smith maintained a supervised inhalation room could help bring crack
users into the health-care system the same way that Insite made health
services and treatment options available to intravenous drug users.

According to a June 2013 report by the B.C. Centre for Excellence in
HIV/AIDS, in 2011, 26.9 percent of people who use drugs in Vancouver
reported smoking crack cocaine on a daily basis. That was down from a
2008 high of 40.7 percent, but well above data from the 1990s, when
daily crack use among drug users generally remained below 20 percent.

Dan Werb, co-founder of the International Centre for Science in Drug
Policy, told the Straight that crack use has declined and leveled off
in recent years, hovering between 20 and 35 percent among drug users

But he argued that Vancouver would still benefit from an inhalation
room. Werb pointed to research suggesting that smoking crack cocaine
is a risk factor for hepatitis C and HIV infection.

For example, an October 2009 paper published in the Canadian Medical
Association Journal states that 13.1 percent of crack users surveyed
became HIV positive during the course of that study. Werb added that
he's observed similar relationships with other risk factors.

"We know that drug consumption rooms reduce risks of overdose, that
they provide people with a safe place to consume their drugs," he
said. "But I'm not aware of any formal proposal to implement or expand
Insite for an inhalation room or an inhalation room somewhere else.
For some reason, I think it's been a bit of a harder sell, not just in
Vancouver, but in other places as well."

Townsend emphasized that there's a room at Insite that could be used
as a supervised inhalation room at a minimal cost.

"Strangely, one of the biggest potential issues for it was the smoking
regulations," he said. "But the red tape can disappear, if there's a
will for red tape to disappear."
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